Portal-Systemic Collaterals: Anatomy and Clinical Implications

  • Kunio Okuda
  • Shoichi Matsutani


As portal venous pressure increases, portal-systemic collateral routes develop, and part of the blood that normally goes to the liver reaches the systemic circulation without coming in contact with hepatocytes. The veins that serve as the collateral channels vary from patient to patient, but the route through the left gastric vein is the most common. This route is responsible for the formation of esophageal varices, the major cause of bleeding. If the size of collateral veins increases to an excessive degree, a major portion of the blood in the superior mesenteric vein, which contains large amounts of nitrogenous substances derived from digested foods absorbed from the gut, flows hepatofugally into the systemic circulation causing encephalopathy. Besides these two major causes of complication of liver cirrhosis, collateral veins are variously implicated in the clinical setting in patients with portal hypertension, particularly cirrhosis.


Portal Hypertension Esophageal Varix Splenic Vein Left Renal Vein Azygos Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Kunio Okuda
  • Shoichi Matsutani
    • 1
  1. 1.Department of MedicineChiba University School of MedicineChiba 280Japan

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